International Conference on Mechanical, Industrial and Energy Engineering 2018

23-24December, 2018, Khulna, BANGLADESH

ICMIEE18-318
Design Construction and Performance Test of a Low-Cost Portable Mechanical Ventilator for
Respiratory Disorder
S. M. Tamjid Hossain1,*, Mihir Ranjan Halder1, Al Aman1, Md. Rakibul Islam2, Md. Tarek Rahman1
1
Department of Mechanical Engineering, Khulna University of Engineering & Technology, Khulna-9203, BANGLADESH
2
Department of Biomedical Engineering, Khulna University of Engineering & Technology, Khulna-9203, BANGLADESH

ABSTRACT
Mechanical ventilator is a medical device which is usually utilized to ventilate patients who cannot breathe adequately on their
own. Among many types of ventilators Bag Valve Mask (BVM) is a manual ventilator in which a bag is pressed to deliver air
into the lungs of the patient. In present work, a mechanical system along with microcontroller has been developed to automate
the operation of BVM. The constructed prototype contains two arms of 0.30 m long, powered by two servo motors through
pulling wires and pulleys, supported by wooden frame. These arms compress the BVM in prescribed manner at the rate set by
the operator through a control knob. With principal dimensions of 0.55m*0.15m*0.3m, weight 2.5 kg and three 9 V battery for
supplying power for at least one hour continuous operation, the prototype can be moved easily. The dimensions of the frame
are selected as such to be compatible with the physical dimension of Ambu bag. The performance of the device was tested
using BIOPAC Airflow Transducer which illustrates that the Tidal Volume vs. Time graph of the automated system is similar
to the graph produced by manual operation of the BVM and to the graph produced by a human subject, but with a mean
deviation of 0.332 Litres with manual operation and 0.542 Litres with human subject. Although the developed device cannot
compress the bag completely due to low powered servo motors, it proves the concept of automating the operation of BVM
using mechanical system for developing a portable ventilator.

Keywords: Mechanical Ventilator, BVM, BPM, Airflow Transducer.

1. Introduction 1.1 History of Mechanical Ventilation

Mechanical ventilation is an important treatment which Numerous works and literatures on the historical
is usually utilized to ventilate patients who cannot development of mechanical ventilation and the design
breathe adequately on their own [1]. Patients with of portable ventilators are available.
underlying lung disease may develop respiratory failure Robert M Kacmarek et al. [5] presented a historical
under a variety of challenges and can be supported by review of various techniques of mechanical ventilation
mechanical ventilators. These are machines which is. It is interesting to note that artificial ventilation is not
mechanically assist patients inspire and exhale, allowing a new or modern concept; rather it can be traced back to
the exchange of oxygen and carbon-dioxide to occur in Biblical times. But modern and automatic devices didn’t
the lungs, a process referred to as artificial respiration appear until the early 1800s. Fig. 1 illustrates a 19th
[2].There are many techniques and methods of artificial century mechanical ventilator which is negative-
ventilation, both manual and mechanical. While modern pressure type. [3]
ventilators are computerized machines, patients can be In the work by Abdo Khoury et al. [6], evolution of
ventilated with a simple, hand-operated bag valve mask Mouth-to-Mouth to Bag-Valve-Mask Ventilation is
(BVM) also. [3] illustrated. Various developments in the components of
Although there are many elegant positive-pressure Ambu bag and its valves are noticeable.
ventilators with sophisticated safety controls, they are
rarely available in the field, thereby forcing arescuer to
resort to manual methods of ventilation [4].
In present work, designing principle of a low-cost
portable mechanical ventilator based on the BVM, along
with the methodology for its construction and
performance test has been described. The prime
objectives of the project are described below.
(1) To design and construct a portable mechanical
ventilator by automating the operation of bag-valve-
mask or ‘Ambu bag’.
(2) To test the performance of the constructed
mechanical ventilator using BIOPAC airflow transducer.
(3) To assess the cost of production of the designed
Fig. 1: A 19th century mechanical
ventilator to justify its use instead of manual
ventilator [4]
resuscitators and existing portable ventilators.

* Corresponding author. Tel.: +88-01728052825

E-mail addresses: tamjid3.14@gmail.com
The article by L. A. Geddes [4] summarizes the history Table 1: Comparison among common portable
of the development of artificial ventilation methods, ventilators [7]
both manual and mechanical. In this article two methods
Model Power for Power for Internal External
of manual artificial resuscitation methods, namely
cycling inspiratory battery electricity
Sylvester’s and Schafer’s method and five mechanical
flow supply supply
devices for artificial ventilation, namely Bellows, the
Pulmotor, the Iron Lung, Cuirass and Rocking Bed are >1 yr
VentiPAC
described in chronological order. Fig. 2 illustrates the Pneumatic Pneumatic (alarm N/A
200D
two manual methods four of the mechanical devices. only)
LTV- Battery
Electric Electric 1h
1000 12V DC
3h
10-32V
Oxylog (NiMH)
Electric Pneumatic DC,
3000 0r 4 h
240V AC
(Li)
The work that is most similar to the present work is by
Husseini et al. [2] in which a BVM is automated
mechanically to construct a portable mechanical
ventilator. Cam mechanism was used in that work to
produce the desired motion of the BVM.
The main difference of the present work with the work
by Husseini et al. [2] is the use of mechanical arms and
servo motors instead of cam mechanism to actuate the
compression of BVM. In section 4.4 the uniqueness of
present work is illustrated further.

2. Theory and Principles

The theoretical background and principle of the
operation of mechanical ventilators and Ambu bag are
presented below.

2.1 Principle of operation of Mechanical Ventilators

Fig. 2 : Artificial Respiration Methods [4]
1.2 Previous Works on the Design of Portable
Ventilators
Stuart Fludger et al. [7] described various types of
portable ventilators and their historical development.
The concept of portable ventilators is rather new
compared to ICU ventilators
Portable ventilators are evolved from the necessity of
ventilating a patient during shifting or moving from one
place to another. Ambu bag is often not reliable or it
cannot be used for the unavailability of trained
personnel. For these reasons, portable ventilators came
into existence.
Portable ventilators vary by different parameters. In
Table 1 comparison among three common portable
ventilators is presented. [7]
Harrison et al. [8] of Rochester Institute of Technology,
New York, developed a traditional portable ventilator
‘Mediresp II’ further. A US patent by Reno L. Vicenzi
et al. [9] describe a detailed construction of a portable
emergency mechanical ventilator.
The ventilator is connected to the patient through a tube
(endotracheal or ET tube) that is placed into the mouth
or nose and down into the windpipe. When the doctor
places the ET tube into the patient’s windpipe, it is
called intubation. Some patients have a surgical hole
placed in their neck and a tube (tracheostomy or “trach”
tube) is connected through that hole. The trach tube is
able to stay in as long as needed and is more secure than
an ET tube. At times a person can talk with a trach tube
in place by using a special adapter called a speaking
valve.
The ventilator blows gas (air plus oxygen as needed)
into a person’s lungs. It can help a person by doing all
of the breathing or just assisting the patient’s breathing.
The ventilator can deliver higher levels of oxygen than
delivered by a mask or other devices. The ventilator can
provide a pressure (PEEP pressure) which helps hold
the lungs open so the air sacs don’t collapse. The tube in
the windpipe makes it easier to remove mucus if
someone has a weak cough. [10]
The ventilator should stop delivering air into the lungs
with external force as soon as the patient starts to
breathe himself. If it operates while the respiratory
system of the patient is active it may cause damage to
the lungs and vomiting of the patient may occur. So,
there is a system to monitor when the patient starts to
breathe himself and stop the operation of the ventilator.

ICMIEE18-318- 2
2.2 Operation of Ambu bag
In Fig. 3 the various parts of an Ambu bag is identified.
Manual resuscitators cause the gas inside the inflatable
bag portion to be force-fed to the patient via a one-way
valve when compressed by the rescuer; the gas is then
ideally delivered through a mask and into the patient’s
trachea, bronchus and into the lungs. The tidal volume
and respiratory rate has to be maintained as per the
conditions of the patients by the rescuer.
Typical tidal volume is 500 to 800 mL of air and typical
respiratory rate is 10 to 12 respiration per minute for
adults and 20 respirations per minute for infants.
Professional rescuers are taught to ensure that the mask
portion of the BVM is properly sealed around the
patient’s face. [11]
Fig. 3: Various parts of Ambu Spur II resuscitator [12]
3. Design and Construction
3.1 Design Assumptions
The design of the proposed portable mechanical
ventilator for adult patients was done on the basis of
following assumptions—
i. Tidal volume to be delivered = 200 to 750 mL
ii. Breath rate to be maintained = 10 to 20 BPM
iii. Maximum power required by the motor = 30 W
iv. Maximum torque to be delivered by the motor = 1.5
N.m
The design assumptions are based on the work by
Husseini et al. [2], as they determined the assumptions
after necessary experiments taking the mechanical
properties and dimensions of the Ambu bag into
considerations. So, there assumptions can be taken
without further experimentations.
3.2 Principle of Proposed Design
Where most emergency and portable ventilators are
designed with all custom mechanical components, it
was chosen to take an orthogonal approach by building
on the inexpensive BVM, an existing technology which
is the simplest embodiment of a volume-displacement
ventilator. Due to the simplicity of their design and their
production in large volumes, BVMs are very
inexpensive and are frequently used in hospitals and
ambulances. They are also readily available in
developing countries. Equipped with an air reservoir
and a complete valve system, they inherently provide
the basic needs required for a ventilator.
The main drawback with BVMs is their manual
operation requiring continuous operator engagement to
hold the mask on the patient and squeeze the bag. This
operating procedure induces fatigue during long
operations, and effectively limits the usefulness of these
bags to temporary relief. Moreover, an untrained
operator can easily damage a patient’s lungs by over
compression of the bag.
The methodology taken has been, therefore, to design a
mechanical device to actuate the BVM. This approach
will result in an inexpensive machine providing the
basic functionality required by mechanical ventilator
standards [2]. In Fig.4, the schematic diagram of the
proposed system is illustrated. To automate the
operation of Ambu bag, the mechanical system
developed to compress the bag must be synchronized
with the ideal motion that is maintained by a
professional rescuer.
Fig. 4: Schematic diagram of the proposed design
3.3 Components Used
The materials and equipment were selected on the basis
of the design assumptions discussed previously.
Materials and components needed to construct the
prototype are presented in Table 2.
ICMIEE18-318- 3
Table 2: Materials and Components used (BPM) value. The Arduino MEGA 2560
Component Rating or Quantity microcontroller was used to control the servo motors. A
Specifications potentiometer was used to control the BPM. The user
1. Ambu Bag Ambu SPUR II PVC 1 can use the knob of the potentiometer to adjust the BPM.
Disposable Manual A LCD screen was used to display the BPM of the
Resuscitator device operating with.
2. Servo Motor MG 996R 2
3. Frame and Arm Wooden, As designed 1 4. Results and Discussion
4. Microcontroller Arduino MEGA 2560 1
5. Project Board 1 4.1 The constructed model
6. LCD Display LCD 1602 1 The constructed model is illustrated in Fig. 6.
7. Battery 9V DC 3
8. Potentiometer 10 K ohm 1
9. Wires and As
Jumpers needed

3.4 The CAD Model

A CAD model of the frame designed is illustrated in
Fig.5. The model is developed using SolidWorks 2013.
The Ambu bag and other components to deliver power
and control the motion is installed on the frame.

Fig. 6: The constructed model

The model automates the operation of BVM. The

principle dimensions are 0.55m*0.15m*0.3m and
weight is 2.5 kilograms. Only three 9V DC battery is
used to operate the device which runs the device
continuously for one hour. So it can easily be carried to
emergency spots. The control knob can be used to adjust
the BPM required for different patients and for different
ventilation settings.

4.2 Performance Test

The developed prototype was tested using Biopac
Fig. 5: The CAD Model of the frame Airflow transducer. The experimental setup is illustrated
in Fig. 7. The transducer along with the Biopac Students
3.5 Dimensions and Calculation of Mechanical LabV4.1 software records the lung tidal volume and
Advantage airflow for every millisecond. In Table 3 data of tidal
The dimensions of the frame and the arms are selected volume for each second is presented. The lung tidal
as such to be compatible with the physical dimension of volume, Vt vs. Time, T graph was obtained for a human
the Ambu bag. The length of the arms is 0.13 meters subject, for the device and for manual operation. In
and in uncompressed state the arms start to touch the Fig.8 the graphs are presented.
bag at 0.13 meters from pivot.
The frame and the arms deliver some mechanical
advantage to compress the bag.
The length of the total arm = 0.3 meters
The length of the portion from pivot to the bag = .13
meters
Mechanical Advantage, M.A. =
So, the arm will provide a M.A. of 2.3 to compress the
bag.

3.6 Control Implementations

The servo motors were coded to be controlled for Fig. 7: Experimental setup
compressing the BVM in required breath per minute

ICMIEE18-318- 4
 powerful motors are used the construction cost will
increase.

Table 4: Construction cost of the prototype

Sector Description Cost
(BDT)
1. Raw materials Wood, PVC arm, PVC 1800
for frame Sheet for pulley etc.
2. Electronic Arduino MEGA, 1700
components Servo motors, LCD,
Potentiometer, Wires
etc.
3. Labor cost - 600
4. Transportation - 400
and testing
Total = 4500
Fig. 8: Tidal volume vs. Time graph
It is assumed that, the cost of commercial production
Table 3: Tidal volume for manual operation of the will be much lesser than prototype construction. The
BVM, for constructed prototype and for a human price range of available portable mechanical ventilators
subject in the market at present varies from $1000 to $9600
(Equivalent to 83,124 BDT to 797,990 BDT) [13].
Time Tidal Volume (Liters)
4.4 Uniqueness of the present work
(Seconds) Manual Prototype Human
The present work is based on the automation of BVM to
0 1.83384 1.3898316 2.195069 construct an emergency portable mechanical ventilator,
1 1.952133 1.5526239 2.191187 similar to the work by Husseini et al. [2]. But in present
2 1.620012 1.3920472 1.629568 work, mechanical arms and servo motors have been
3 1.927859 1.384977 2.264765 used to actuate the BVM, whereas, Husseini et al. used
4 2.188488 1.5493066 2.466729 cam mechanism for the purpose.
5 1.546177 1.3887128 1.787522 The technique used in present work proves to be more
effective as it permits programming the required
6 1.796241 1.384977 1.998717 compression pattern, while in cam mechanism the
7 2.005329 1.5493066 2.453686 compression pattern is fixed and unchangeable. So,
8 1.486377 1.3887128 2.007818 more controllability is achieved by implementing
9 1.765406 1.3898316 1.874575 mechanical arms and servomotors to actuate the BVM.
10 2.071216 1.5526239 2.354588
11 1.584592 1.3920472 2.353157 4.5 Discussions
The prototype could not compress the Ambu Bag
12 1.730899 1.3843648 1.892085
completely. It compresses the bag partially. The reason
13 2.040938 1.5489166 2.734889 behind this might be—
14 1.421615 1.3886887 1.82856 i. The motors were not powerful enough to
15 1.429697 1.384977 1.46641 compress the bag.
16 1.738724 1.5493066 2.109159 ii. The frictions among the mechanical linkages
17 1.845986 1.3887128 1.984328 absorbed reasonable power.
18 1.550398 1.3855922 1.733285 iii. The prototype could not be built precisely due
to lack of precise construction tools.
19 1.856896 1.5450019 2.261398
Though, the prototype works as a proof-of-concept in
20 1.862131 1.3855323 2.118213 automating the operation of Ambu Bag. In future
developments of the prototype these problems may be
The mean deviation of the tidal volume obtained by the resolved.
prototype from manual operation was 0.332 Liters or
332 mL and from human subject was 0.542 Liters or 5. Conclusions
542 mL. The project work proves the concept of automating the
Ambu bag or BVM for developing a low cost portable
4.3 Cost analysis mechanical ventilator. Improvements of the model will
The total construction cost of the prototype was lead to a successful and useable portable mechanical
approximately 4500 Taka. The details of the cost are ventilator for actual emergency cases where existing
presented in Table 4. It should be noted that, if more sophisticated devices are not present. Although the

ICMIEE18-318- 5
device cannot perform like existing devices, its low cost Care & Pain, vol. 8, no. 6, pp. 199-203, 2008.
justifies its use in emergency cases. [8] M. Harrison, R. Muckel, C. Freeman, M. Revekant,
With three 9 volts battery as power supply the prototype D. Fenton, D. Zielinski, K. Kong, D. Engell and E.
can operate continuously for one hour. With principle Welch, "PORTABLE EMERGENCY
dimensions of 0.55m*0.15m*0.3m, and weight 2.5 VENTILATOR," in Multidisciplinary Senior
kilograms, the prototype may easily be transported. It Design Conference, Rochester Institute of
also have a feature to control the breath rate and a LCD Technology, Rochester, New York, 2013.
display shows the BPM the device is operating with.
[9] R. L. Vicenzi and T. R. Findlay, "PORTABLE
6. Future development scopes LIGHT WEIGHT COMPLETELY SELF-
Following developments might be implemented for a CONTAINED EMERGENCY SINGLE PATIENT
usable portable mechanical ventilator— VENTILATOR/RESUSCITATOR". USA Patent
i. More powerful servo motors can be used. 4,905,688, 6 March 1990.
ii. DC motors can be used along with DC motor [10] "Mechanical Ventilation," [Online]. Available:
controller to reduce the cost and increase the www.thoracic.org. [Accessed 11 April 2017].
driving torque. [11] "Bag valve mask," [Online]. Available:
iii. More features can be implemented to control https://en.wikipedia.org/wiki/Bag_valve_mask.
various ventilation parameters like tidal [Accessed 19 April 2017].
volume, inspiration to exhalation time ratio etc. [12] C. Nickson, "Bag-Valve-Mask (BVM)
Ventilation," 6 May 2018. [Online]. Available:
NOMENCLATURE https://lifeinthefastlane.com/ccc/bag-mask.
[Accessed 29 October 2018].
BVM Bag-Valve Mask
ICU Intensive Care Unit [13] "AliBaba.com," [Online]. Available:
ET tube Endotracheal tube https://www.alibaba.com/showroom/mechanical-
BPM Breath Per Minute ventilation-price.html. [Accessed 20 February
M.A. Mechanical Advantage 2018].
LCD Liquid Crystal Display
Vt Tidal Volume

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